Inflammatory Bowel Disease - What is it and what do I do?
Inflammatory bowel disease is a term used to cover a couple of individual diseases; Crohn’s, ulcerative colitis, microscopic colitis (lymphocytic and collagenous), and ischemic colitis. All of these diseases differ slightly and affect different portions of the gastrointestinal (GI) tract. As the name implies the most common thing in all of these diseases is inflammation. So even though there are different characteristics between the types of IBD, treatment for all of them is aimed at reducing inflammation.
Rates of IBD are on the rise and are now noticeable in other countries where Western diets are becoming main stream. This gives us a clue as to what can be an underlying cause. Most cases of IBD are diagnosed before age 40 so it is not a disease of “the old” and tends to affect women more so than men.
IBD is considered an autoimmune disease or at least many believe it has an autoimmune component to it. As with any autoimmune disease the body starts to attack itself. In the case of IBD it is an abnormal attack against normal food and bacteria that are found in your gut. The foods that usually create this reaction are grain and dairy based foods. Over time the constant reaction you have to these foods begins to destroy the protective lining of the GI tract and can lead to leaky gut. Leaky gut can enhance the inflammatory response which keeps the whole cycle going. Due to this, malabsorption, malnutrition, and nutrient deficiencies are common in people who suffer from IBD.
As with many diseases, current theories suggest there is a genetic component to IBD but as I say a lot of the time this doesn’t mean you will automatically develop a particular disease. I believe genetics can make you more susceptible to a disease but if you can avoid the triggers you can avoid the disease or minimize its impact in a lot of cases.
Some of the symptoms experienced with IBD:
Abdominal pain and cramping
Fever, weight loss, and inability to gain weight.
Some triggers of IBD can include:
Loss of friendly gut bacteria
Inflammation of the blood vessels in the gut (often seen in ischemic colitis)
Chemical and environmental sensitivities
Hypersensitivity to antigens (anything that causes your immune system to produce antibodies against it) in the gut such as tissue, food, or bacteria
Use of oral contraceptives (especially in those who are genetically prone to IBD)
75% of our immune cells are in the gut. Our beneficial gut bacteria (microbiota) has an enormous impact on our immune system and have an immune function themselves. This is why it is so important to keep the balance between good and bad bacteria in the gut. In almost all cases of IBD there is an imbalance between the good and bad bacteria (dysbiosis). This imbalance affects immune function and can lead to autoimmunity and can even cause the immune system to attack the good bacteria and food particles.
Common bad bacteria involved include E.coli, staphylococcus, streptococcus, and Clostridium difficile toxin to name a few. Countering this with probiotics such as Lactobacillus and Bifidobacterium is a common tactic used to treat symptoms of IBD.
Due to the overactivity of the immune system to food, gut flora, and even the lining of the GI tract itself, inflammation causes the cells that line the small intestine to open up. These tight junctions are there to protect us from foreign invaders and only allow a certain amount of immune cells in to kill bad bacteria when inflammation is present. In the case of chronic inflammation, IBD, more immune cells enter the area because the gaps never close and attack anything and everything they see, including the gut wall.
How to deal with IBD
As mentioned above IBD is actually a term used to cover a couple of individual diseases. These are some general recommendations covering IBD. If you feel you may have IBD and want to investigate further book in and see your doctor so you know what you are dealing with. In saying that I believe if you implement the following you will help relieve some of your symptoms.
In many cases of IBD the GI tract is so damaged that we tend to run a nutritional cleanse to give the GI tract a rest. Typically we use medical foods to do this. Medical foods are hypoallergenic foods that contain proteins, fats, and carbohydrates that have been broken down into single amino acids, fatty acids, and simple carbohydrates so that no digestion is necessary. This allows inflammation to settle down and leaky gut to heal.
Many cases of IBD are triggered and symptoms enhanced by food sensitivities and inflammatory foods. Some foods to eliminate right away are sugars, alcohol, fast foods, grains, dairy and wheat. Now you may think well what’s left to eat? There is plenty. You want to try and eat whole foods wherever possible. Foods such as grass fed meat, fish, poultry, vegetables, nuts, seeds, and small amounts of fruit.
Try to eat warm cooked foods where possible as they are easier to digest.
A lot of people may not be able to eat the heavier meats as digestion is normally impaired so I tend to recommend fish and the lighter types of meat.
By following the above recommendations you will also be eliminating sources of yeast. This is important as a high percentage of people with Crohn’s have antibodies to baker’s and brewer’s yeast. If the above doesn’t relieve any symptoms you may want to eliminate histamine containing foods as well.
Many people recommend an elimination diet to find the culprits which cause their symptoms to flare up. I think this is a good idea. My advice is to try an elimination diet but if you want to confirm a food sensitivity I would suggest running some of the functional labs I suggest later on.
Chemical and environmental sensitivities
Many products we use to clean our homes, wash our dishes, and even clean ourselves can lead to, or flare up GI symptoms. Two surfactants (chemicals), dextran sodium sulfate (DSS) and sodium lauryl sulfate (SLS) are commonly used to induce colitis in mice and are known to irritate the intestine. These chemicals can be found in soap, shampoo, body wash, laundry detergent, and toothpaste to name a few. This is why I always buy a toothpaste that is SLS free which you can easily buy from any grocery store.
There are many other chemicals we are exposed to in our environment that can cause problems to the GI tract so it is important to try and limit your exposure as much as possible. Another thing you can do is install a whole house water filter or at the least drink filtered water and buy a shower filter so that you minimize your exposure to chlorine. Chlorine kills bacteria but doesn’t differentiate between good or bad. It kills the good bacteria as well as the bad and this can be a problem for people with IBD who are already likely to have dysbiosis as we spoke of earlier. Chlorine can be absorbed through the skin so it’s a good idea to fit one of those shower filters and not swim in chlorine pools.
It is important to check labels if you suffer from IBD and know what you are being exposed to in your environment.
These are just some examples. Moulds, bacteria, viruses, chemicals, can all play apart in your IBD symptoms. It could be something as innocuous as your deodorant.
Medications and supplements
Medical treatment for IBD often consists of anti-inflammatory drugs, steroids, immune suppressors, and sometimes antibiotics. These medications can help relieve symptoms but do not address the underlying causes of IBD and have side effects of their own. Bone loss, low cortisol, and nutrient deficiencies are some of the side effects associated with these medications and by taking immune suppressing drugs you make yourself more vulnerable to other diseases.
Medications are often necessary to help alleviate symptoms but I feel they should be used in conjunction with natural therapies to lessen the need for medications. This enables the medications to work more effectively when you do have a flare up and reduce the need for them at other times. The other reason why I like to use natural therapies is that they address the underlying factors of the disease.
When you are well it is important to take care of yourself, use stress management techniques, and avoid triggers where possible to reduce flare ups.
Our approach to IBD often starts with a nutritional cleanse as mentioned above. We also like to do a gut rebuilding protocol that deals with inflammation, nutrient deficiencies, and helps heal the lining of the GI tract. We also support digestion and detoxification pathways.
Some of the supplements we like to use are as follows:
Probiotics – dysbiosis is often seen in people with IBD. To help restore balance to the microbiota we like to use different types of probiotics over a long period of time. Although probiotics are a good help it is important to not over do them thinking more is better. Some people with IBD are unable to tolerate large doses of probiotics so it’s important to go slowly. Probiotics have also been shown to help deal with inflammation.
Multivitamin – this is standard for all of our clients. A multi is an insurance policy. It addresses any nutritional insufficiencies and helps fill any holes that aren’t provided by the diet.
Antioxidants – with inflammation playing such a big role in IBD it increases levels of free radicals which damage the DNA and cell membranes. This process is known as oxidative stress or oxidative damage. Antioxidants help reduce this damage. There are many good choices of antioxidants but I like to rotate them at specific times to enhance their effectiveness.
Glutamine – we use glutamine all the time for gut health. It is the most abundant amino acid in our bodies. It is effective for healing stomach ulcers, IBS, and ulcerative bowel disease.
This list is far from comprehensive. We use many other supplements such as curcumin and omega-3 fatty acids but we tailor our supplement recommendations to the individual depending on what their needs are. Blanket supplement regimes are no better than just throwing darts at a list of all the beneficial supplements on a board and using them because they have been shown to help with IBD or any other disease for that matter.
This is why we offer functional lab testing to our clients who need it. We can find out exactly what nutrients they are deficient in, if they have hormonal imbalances, what foods they are sensitive to, what chemicals are problematic for them, if they have dysbiosis or leaky gut, parasites, fungus, what their amino acid, fatty acid, organic acid profiles are, and we can then individualise a nutritional, lifestyle, exercise, and supplementation plan that is most beneficial for them.